As a woman, you often serve as the backbone for your family and community. While your resilience may be strong, unfortunately, the same cannot always be said for the strength of your bones.

According to the Centers for Disease Control and Prevention, women make up a significantly higher percentage of Americans with osteoporosis compared to men, accounting for around 80% of the 14.1 million Americans aged 50 and older who have the condition. Additionally, In serious a woman’s risk of breaking a hip is significantly higher to her combined risk of breast, uterine and ovarian cancer. cases, even just sneezing could cause a fracture.

That’s why getting to know your bone density and issues that can impact it are so important. To better understand what osteoporosis is, its risk factors, and practical steps individuals can take to prevent it and maintain strong, healthy bones, we spoke with Nancy McDonald, MHA, CRA, CNMT, the director of radiology at Women’s Diagnostic and Breast Center at Texas Health Dallas.

What is Osteoporosis?

Osteoporosis is a condition characterized by weakened and fragile bones, often resulting from a loss of bone density and mass. It increases the risk of fractures, particularly in the hip, spine, and wrist. Essentially, it's like your bones losing their strength and becoming more susceptible to fractures, even from minor falls or injuries.

How strong your bones are and how susceptible they are to breaking is, in basic terms, referred to as your bone density. Higher bone density indicates stronger bones, while lower bone density may indicate bone weakening, which can lead to conditions like osteoporosis.

Osteoporosis typically develops gradually over time and because osteoporosis can often go unnoticed until a fracture occurs, it’s important to recognize risk factors for early detection and prevention.

Risk Factors for Osteoporosis

Osteoporosis isn't reserved for just the older generation  — it can catch anyone off guard. Certain factors can heighten your risk of developing it, falling into two categories: those beyond your control and those you can influence through lifestyle adjustments.

Women over the age of 65 and men ages 50-70 are at increased risk of osteoporosis if they have:

• A broken bone caused by normal activities, such as a fall from standing height or lower
• Chronic rheumatoid arthritis, chronic kidney disease, eating disorders
• Early onset of menopause (before age 45)
• History of hormone treatment for prostate cancer or breast cancer
• Significant loss of height due to compression fractures of the back
• Three or more drinks of alcohol per day on most days
• Family history of osteoporosis or fractures
• Long-term use of medications that affect bone density (e.g., corticosteroids)
• Lifestyle factors like smoking, excessive alcohol consumption, and sedentary behavior

Having one or more risk factors does not mean that it’s a guarantee you will have osteoporosis. However, the more risk factors you have, the greater your chance of developing the disease.

“One thing we see quite often is people are shocked when they are diagnosed with osteoporosis or osteopenia because they have no history of the condition in their family, or should I say no known history,” McDonald says. “It’s bit less common now, but back in the day, it wasn’t uncommon that older people had the condition and had no clue because they weren’t formally diagnosed. So, just because you don’t have a family history doesn’t mean you’re in the clear.”

Screening and Diagnosis

One effective way to proactively address osteoporosis is to understand your bone health status — essentially, where your bones currently stand. Bone density screening is a great way to do that.

Bone density screening, also known as bone densitometry or dual-energy X-ray absorptiometry (DEXA), is a diagnostic test used to measure bone mineral density (BMD). It helps in assessing the strength and density of bones, particularly in areas prone to fractures such as the spine, hip, or wrist.

This non-invasive procedure utilizes low-dose X-rays to detect signs of osteoporosis or osteopenia (a precursor to osteoporosis).

Regular bone density screenings are essential for early detection of bone loss and osteoporosis, allowing for timely interventions to prevent fractures and maintain bone health.

“You don’t need to see a specialist to get a referral for a bone density screening,” McDonald says. “Primary care providers and OB/GYNs are who we see the most referrals from because they’re often that first point of care for so many people. Whoever you see for your general wellness is most likely going to be able to do a preliminary screening for risk factors, and then potentially order a bone density scan for you as well.”

Additionally, if you have been diagnosed with osteoporosis or osteopenia, regular bone density assessments can help evaluate the effectiveness of osteoporosis medications, guiding treatment adjustments as needed to optimize outcomes.

By quantifying bone density, DEXA scans can help your doctor have a clearer idea of your individual risks, allowing for targeted preventive strategies.

According to the US Preventive Services Task Force, DEXA bone density screenings are recommended starting at age 65 for women at an average risk of osteoporosis. While no screening guidelines exist for men, they may consider talking to their doctors about the screening starting at age 70.

Prevention and Reducing Further Bone Loss

Whether you’re at an increased risk of developing osteoporosis or not, maintaining strong and healthy bones is essential for overall well-being. Fortunately, there are several proactive steps you can take to reduce your risk:

• Get Adequate Calcium and Vitamin D: Ensure you're getting enough calcium and vitamin D in your diet to support bone health. Good sources of calcium include dairy products, leafy green vegetables, and fortified foods. Vitamin D can be obtained from sunlight, fortified foods, and supplements.
• Engage in Low-Impact Exercise: Regular weight-bearing and muscle-strengthening low-impact exercises, such as walking, jogging, dancing, and strength training, help build and maintain bone density.

“Yoga is often recommended because it’s a bit gentler and something that can be a little less daunting for those who haven’t exercised in a while,” McDonald adds. “It’s a low-impact way to stimulate bone strength and strengthen muscles to help support and protect your bones. It also has the added benefit of improving your balance and coordination, which can prevent falls.”

• Quit Smoking: Smoking can decrease bone density and increase the risk of fractures. Quitting smoking can improve bone health and overall well-being.
• Limit Alcohol Consumption: Excessive alcohol consumption can weaken bones and increase the risk of fractures. Limit alcohol intake to moderate levels or avoid it altogether.
• Maintain a Healthy Body Weight: Being underweight increases the risk of osteoporosis. Aim to maintain a healthy body weight through a balanced diet and regular exercise.
• Avoid Excessive Caffeine: High caffeine intake may interfere with calcium absorption and contribute to bone loss. Limit caffeine consumption from sources such as coffee, tea, and caffeinated sodas.

“Caffeine may be something that shocks people, but oftentimes items containing caffeine don’t provide much nutritional value and can even deplete nutrients in our bodies,” McDonald adds.

Additionally, you should take steps to prevent falls wherever and whenever you can. Spot problem areas in your home and make adjustments, such as removing tripping hazards, ensuring proper lighting, especially at night, and using assistive devices if needed.

If you’re diagnosed with osteoporosis osteopenia, your doctor will recommend some comprehensive management strategies aimed at preventing further bone loss and reducing fracture risk.

Treatment may include:

• Medications: Various medications, such as bisphosphonates, selective estrogen receptor modulators, and denosumab, are prescribed to enhance bone density and reduce fracture risk.
• Calcium and Vitamin D Supplementation: Adequate calcium intake, typically supplemented with vitamin D to optimize absorption, is essential for maintaining bone health and minimizing bone loss.
• Surgical Interventions: If your bone less is severe, surgery such as vertebroplasty or kyphoplasty, may be suggested. These minimally invasive procedures involve injecting bone cement into fractured vertebrae to stabilize them and reduce pain.

Additionally, your doctor may ask you to follow the preventive measures we listed earlier to help prevent further bone loss.

The Takeaway

In conclusion, understanding osteoporosis and taking proactive steps to prevent it are crucial for maintaining strong and healthy bones as we age. By adopting a bone-healthy lifestyle, staying informed about risk factors, and seeking appropriate medical care, you can reduce your risk of osteoporosis and enjoy a better quality of life in the years to come.

“It’s really important that you stay on top of your bone health, because once you lose it, there’s no way to get it back,” McDonald stresses. “The best you can do is help prevent further bone loss. So, stay on top of your risk factors, make those lifestyle changes and get your screenings if you’re eligible.”

For more information on bone density testing visit TexasHealth.org/BoneDensity.